The elimination of oral health disparities and the prevention of tooth loss due to periodontal disease and dental caries are central goals of Healthy People 2010. The burden of tooth loss in the U.S. is disproportionately high among African Americans when compared to whites. African Americans also have the highest prevalence of vitamin D insufficiency, a condition that is extremely common in the US. Vitamin D may affect the risk for periodontal disease and tooth loss through its canonical effect on bone, as well as its immuno-modulatory effects. Furthermore, the large racial disparities in vitamin D status may at least partially explain the existing racial disparities in tooth loss. Our long-term goal is to determine the role of vitamin D in the prevention of chronic periodontitis and tooth loss, with the aim of reducing or eliminating oral health disparities. The major objective of this application is to evaluate whether vitamin D status is associated with the incidence of tooth loss. The proposed epidemiologic study will make efficient use of existing data on vitamin D status, other health related variables and incident tooth loss over 18 years as previously obtained in the Health Professionals Follow-up Study (HPFS) between 1986 and 2004. Data on blood concentrations of 25-hydroxyvitamin D are available for a sub-sample 1,637 men. In addition, we will use known determinants of vitamin D status (vitamin D intake, race, physical activity, body mass index and region) to estimate long-term vitamin D status for the entire cohort, based on a previously validated prediction rule. We will test whether these measures of vitamin D status are associated with the risk of tooth loss. This cohort of health professionals is particularly suited to address this question, because self-report of tooth loss is extremely accurate and the study population is relatively homogeneous in regards to socio-economic determinants of tooth loss. This proposal has important public health implications because of the high prevalence of both vitamin D insufficiency and tooth loss. Supplementation with vitamin D at adequate doses may be a simple, safe and inexpensive means to reduce the overall burden of tooth loss in the population and to reduce racial disparities in tooth loss. [unreadable] [unreadable] [unreadable]